| 刘如安.耐碳青霉烯类肺炎克雷伯菌下呼吸道感染患者临床特征及危险因素分析.[J].中南医学科学杂志.,2020,(2):141-145. |
| 耐碳青霉烯类肺炎克雷伯菌下呼吸道感染患者临床特征及危险因素分析 |
| Clinical characteristics and risk factors of lower respiratory tract infection caused by carbapenem-resistant Klebsiellapneumoniae |
| 投稿时间：2019-10-11 修订日期：2019-12-29 |
| DOI：10.15972/j.cnki.43-1509/r.2020.02.008 |
| 中文关键词: 耐碳青霉烯 肺炎克雷伯菌 下呼吸道感染 危险因素 |
| 英文关键词:carbapenem Klebsiellapneumoniae lower respiratory tract infection risk factor |
| 基金项目: |
|
| 摘要点击次数: 592 |
| 全文下载次数: 392 |
| 中文摘要: |
| 收集60例下呼吸道感染耐碳青霉烯类肺炎克雷伯菌(CRKP)患者(观察组)的临床资料,另选择同期仅感染碳青霉烯敏感的肺炎克雷伯菌(CSKP)患者492例为对照组,分析CRKP感染的临床特征,并比较两组临床资料。结果显示:60例病例主要来自神经内科重症监护室(ICU)、呼吸内科ICU、综合ICU。45例有脑血管病需长期卧床存在吞咽功能障碍,10例需维持气管切开状态,19例之前使用过碳青霉类抗菌药物,31例检出该菌前均使用过酶抑制剂等多种药物但未用碳青霉烯,药敏有效药物为米诺环素、替加环素及磺胺；单因素及多因素Logistic回归分析显示,住ICU时间≥5天、合并脑血管疾病、序贯性器官衰竭估计评分(SOFA)、深静脉置管、气管切开插管、2周内使用过耐碳青霉烯类抗菌药物、使用抗生素种类≥3种、营养状况差为导致下呼吸道感染患者CRKP的独立危险因素(P＜0.05)。因此,下呼吸道CRKP感染形势严峻,长期住ICU,脑血管病吞咽功能障碍、气道分泌物引流不良、气道开放、广谱抗生素的使用、营养状态差是CRKP感染的危险因素。 |
| 英文摘要: |
| patients with lower respiratory tract infection caused by carbapenem resistant Klebsiellapneumoniae (CRKP) (observation group) were analyzed retrospectively. Another 492 patients with carbapenem-susceptible K. pneumoniae (CSKP) were selected as the control group. The clinical characteristics of CRKP infection were analyzed. The results showed that 60 patients with CRKP infection were mainly from the intensive care unit (ICU) of neurology department, ICU of respiratory medicine department and integrated ICU. The remaining 9 non-ICU patients lived in the integrated ICU before infection. 45 cases stayed in bed for a long time due to cerebrovascular diseases and had dysphagia, 10 cases needed to maintain incision of trachea, 19 cases had used carbapenem antibiotics before, and 31 cases had used enzyme inhibitors and other drugs before the bacteria were detected but not used with carbapenem. Drug sensitivity test showed that effective drugs included minocycline, tigecycline and sulfonamide. Univariate and multivariate Logistic regression analysis showed that ICU stay ≥ 5 d, with cerebrovascular disease, sequential organ failure assessment (SOFA) score, deep vein catheterization, tracheostomy intubation, having used carbapenem-resistant antibiotics within 2 weeks, antibiotics used ≥ 3 kinds and poor nutrition were independent risk factors for CRKP in patients with lower respiratory tract infection (P<0.05). So CRKP infection of lower respiratory tract infection is in serious situation. Long-term stay in ICU, cerebrovascular disease with dysphagia, poor drainage of airway secretion, open airway, use of broad-spectrum antibiotics and poor nutritional status are risk factors for CRKP infection. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|